Background: Delirium is associated with increased duration of mechanical ventilation, longer intensive care unit (ICU) length of stay, increased mortality and cognitive impairment after discharge. Quetiapine has been associated with faster resolution but long-term use is associated with adverse effects. Patients are often discharged from the ICU and subsequently from the hospital on quetiapine without [...]

Background: Adverse drug events (ADEs) are common during transitions from the hospital to the ambulatory setting, with approximately 20% of patients experiencing an ADE within 30 days of discharge. ADEs are often due to patient misunderstanding of the prescribed medication regimen or non-adherence to the regimen.  New approaches are needed to address this problem. Purpose: [...]

Background: Given the widespread adoption of electronic health record systems, the majority of patient orders are now enacted through electronic orders. We aimed to describe the average number of electronic orders entered for medicine patients hospitalized at different levels of care and determine if electronic ordering patterns reflected patient acuity and severity of illness. Methods: [...]

Background: The systematization of the teaching and training of internal medicine residents should be done with the standardization of techniques, simulations, use of manikins and theoretical lessons. A procedure team was created in a tertiary teaching hospital at south Brazil with the objective of minimizing risks to the patient at the same time optimizing the [...]

Background: Increased asthma and obesity prevalence are independently associated with health disparities.  This study sought to examine the relationship between these two conditions, particularly within the pediatric population at a major inner city teaching hospital. Methods: Patients aged 3 to 18 with a diagnosis of bronchial asthma and at least one hospital encounter for an [...]

Background: Bronchiolitis is a clinical diagnosis, with growing research supporting limited use of diagnostic tests and interventions. Hospitals have reduced use of bronchodilators and imaging, but the national average of respiratory viral testing (RVT) in these children continues to be high at 33%. Over the past three years, RCHSD’s rate has persisted at 31-35%, despite [...]

Background: Maternal chorioamnionitis usually means an otherwise healthy appearing newborn gets cultured and treated for presumptive bacterial infection pending culture results. This is often done in a NICU setting. These babies are overwhelmingly well and are discharged after they ‘rule out’. However, the need for additional treatment and care in a NICU setting as well [...]

Background: Many pediatric hospitalist programs in community hospitals around the country function with a 24-hour shift model for 24/7 coverage. This creates significant discontinuity and daily inefficiencies in patient care. Furthermore, there is a robust amount of adult literature that points to the benefits of both inpatient and outpatient continuity of care. When our community [...]

Background: Surgical site infections (SSI) can complicate any operative procedure although this risk is mitigated through the use of preoperative antibiotic prophylaxis.  While antibiotic prophylaxis can provide great benefit, inappropriate use can lead to the development of multi-drug resistant organisms causing increased morbidity, mortality, and cost. Although national clinical guidelines for preoperative antibiotics prophylaxis were [...]

Background: Severe aortic stenosis (SAS) had been identified as being at elevated risk for non-cardiac surgery. However, two reports demonstrated that SAS did not increase mortality of intermediate to high risk non-cardiac surgery. The European Society of Cardiology guideline states non-cardiac surgery of low to intermediate risk can be safely performed among patients with SAS. [...]